A wide variety of mental and physical processes are controlled or influenced by neural activity in particular regions of the brain. For example, the neural functions in some areas of the brain (i.e., the sensory or motor cortices) are organized according to physical or cognitive functions. In general, particular areas of the brain appear to have distinct functions in most individuals. In the majority of people, for example, the areas of the occipital lobes relate to vision, the regions of the left interior frontal lobes relate to language, and the regions of the cerebral cortex appear to be consistently involved with conscious awareness, memory, and intellect.
Many problems or abnormalities with body functions can be caused by dysfunction, damage, disease and/or disorders in the brain. Effectively treating such abnormalities may be very difficult. Epidemiological profiles indicate that the treatment and/or rehabilitation of neurologic dysfunction is extremely challenging due to patient population heterogeneity, for example, due to factors such as age, gender, ethnicity, cause, physiologic location, severity, and time since onset. For most patients exhibiting neurologic damage arising from, for example, a stroke, conventional treatments are not sufficient, and little can be done to significantly improve the function of an affected body part or cognitive function beyond the limited recovery that generally occurs naturally without intervention.
A stroke is a common condition that damages the brain. Strokes are generally caused by emboli (e.g., obstruction of a vessel), hemorrhages (e.g., rupture of a vessel), or thrombi (e.g., clotting) in the vascular system of a specific region of the brain, which in turn generally cause a loss or impairment of a neural function (e.g., neural functions related to facial muscles, limbs, speech, etc.). Stroke patients are typically treated using various forms of physical therapy to rehabilitate the loss of function of a limb or another affected body part. Stroke patients may also be treated using physical therapy plus drug treatment.
Certain types of electromechanical or robotic systems may enhance particular types of physical therapy rehabilitation activities. For example, interactive robotic devices may dynamically interface with patients to focus on motor skills by guiding the patient through a series of exercises. Known robotic assist devices targeting arm/hand rehabilitation provide a movable member for the patient to manipulate. The robotic rehabilitation devices may provide a patient with a series of movements to perform with mechanical assistance and/or resistance to aid in coordination and muscular development.
Functional Electrical Stimulation (FES) generally refers to systems and methods that apply electrical signals to peripheral nerves to restore partial or adequate function to particular muscles in the body that are otherwise paralyzed due to damaged or dysfunctional neural signaling pathways, e.g., due to spinal cord injury, stroke, disease, or other conditions. These conditions can break or otherwise disrupt the path or paths by which electrical signals generated by the brain normally travel to neuromuscular groups to effectuate coordinated muscle contraction patterns. As a result, even though the majority of nerves along a given signaling pathway may be intact, essentially no physiological signals are received from the spinal cord, and in turn the associated body parts do not function. FES systems and methods attempt to compensate for the disrupted, damaged, or dysfunctional physiological signaling pathways, and restore some function to the still intact muscles and nerves. Such systems and methods are known, e.g., to aid finger-grasp functions to muscles in the arm and hand; restore control to intra-cavity muscles, e.g., in the bladder or bowel; or enhance standing and/or gait function involving muscles in the hip and legs.
Although preexisting systems and methods may provide a certain level of benefit to individuals undergoing treatment and/or rehabilitation for neurologic dysfunction, such benefit is typically undesirably limited and many quality of life issues still remain. There is a need for systems and methods capable of providing more effective or sustained neurofunctional benefit.